ABSTRACT
Objectives
Although epidemiological surveys of paediatric rheumatic diseases in Japan have been conducted, they were single surveys with no continuity. This is the first report of the ...Pediatric Rheumatology Association of Japan registry database, which was established to continuously collect data for paediatric rheumatic diseases.
Methods
Pediatric Rheumatology International Collaborate Unit Registry version 2 (PRICUREv2) is a registry database established by the Pediatric Rheumatology Association of Japan. The registry data were analysed for the age of onset, time to diagnosis, sex differences, seasonality, and other factors.
Results
Our data showed the same trend regarding rates of paediatric rheumatic diseases reported in Japan and other countries. The age of onset was lower in juvenile idiopathic arthritis (JIA) and juvenile dermatomyositis and higher in systemic lupus erythematosus and Sjögren’s syndrome. The time to diagnosis was relatively short in JIA and systemic lupus erythematosus but longer in juvenile dermatomyositis and Sjögren’s syndrome. Rheumatoid factor-positive polyarticular JIA showed a seasonality cluster with regard to onset.
Conclusion
PRICUREv2 aided the retrieval and evaluation of current epidemiological information on patients with paediatric rheumatic diseases. It is expected that the data collection will be continued and will be useful for expanding research in Japan.
Background: There are few studies evaluating the distribution of successful ablation sites of idiopathic right ventricular outflow tract (RVOT) arrhythmias using a three‐dimensional electroanatomical ...mapping system. This study aims to clarify the favorite site of idiopathic RVOT arrhythmias through electroanatomical voltage mapping using the CARTO system (Biosense Webster, Diamond Bar, CA, USA).
Methods: A consecutive series of 72 patients (mean age 43.6 ± 16.2 years, 32 males) who underwent radiofrequency catheter ablation (RFCA) for a total of 82 morphologies of idiopathic RVOT arrhythmias were studied. Detailed three‐dimensional electroanatomical voltage maps of the RVOT were obtained using the CARTO system prior to the RFCA during sinus rhythm. The voltage on bipolar electrogram was defined as follows: amplitude < 0.5 mV as “low‐voltage zone,” amplitude between 0.5 and 1.5 mV as “transitional‐voltage zone,” and amplitude >1.5 mV as “high‐voltage zone.” Successful ablation sites were electroanatomically classified into each voltage zone.
Results: Successful ablation was acquired in 63 patients and 71 RVOT arrhythmias (63/72 patients: 87.5%, 71/82 RVOT arrhythmias: 86.5%). In the successful group, three arrhythmias (4.2%) were classified in the low‐voltage zone, 63 arrhythmias (88.7%) in the transitional‐voltage zone, and five arrhythmias (7.0%) in the high‐voltage zone.
Conclusions: This study indicates that the vast majority of successful ablation sites for idiopathic RVOT arrhythmias are located in the transitional‐voltage zone. Mapping of the transitional‐voltage zone may be an important landmark of RFCA for RVOT arrhythmia.
Purpose
To compare the clinical midterm results in ADVANCE total knee arthroplasty (TKA) with double-high (DH) insert, with same type implant with medial-pivot (MP) insert.
Method
Forty ADVANCE TKAs ...were randomly divided into two groups, and two different design insert, DH insert, and MP insert were used in each group. At midterm, 4–5 years after surgery, Knee Society Scores (KSS), Knee Society Functional Scores (KSFS), range of motion (ROM), and UCLA activity score were assessed and reported in this study.
Results
Midterm clinical results, including ROM and KSS, were comparable with both groups. KSFS and UCLA activity score were equally good between the two groups.
Conclusion
The results in this study revealed equally good clinical results with these types of implants at midterm follow-up, although the significant better ROM has not achieved by using DH insert. We concluded that the selection of inserts only could not achieve the better clinical results, including ROM and activity level in this study.
Level of evidence
Therapeutic studies—investigating the results of treatment, Level II.
Lumbar spinal instability was evaluated using radiographic parameters and intraoperative biomechanical measurement.
To validate a conventional radiographic assessment using an intraoperative ...biomechanical measurement and to determine the radiographic parameters indicating anterior column support in lumbar spinal fusion.
Posterior lumbar interbody fusion is gaining acceptance in the treatment of degenerative spondylolisthesis, whereas posterolateral fusion alone may result in good clinical outcomes. A quantitative biomechanical assessment of spinal instability is essential to determine the optimal method of spinal arthrodesis.
Nineteen cases with symptomatic degenerative spondylolisthesis were included in this study. All were candidates for pedicle-screw instrumented lumbar arthrodesis. A total of five L3-L4 segments and seventeen L4-L5 segments were investigated. Radiographic assessment included disc angle, range of motion (ROM), percent of slip, and percent of posterior disc height. Distraction stiffness of the operative segment was measured intraoperatively using a strain-gauged spreader.
Disc angle in flexion and ROM were highly correlated to distraction stiffness. Severity of slip, disc space narrowing, and facet tropism did not influence the distraction stiffness. The cases with segmental kyphosis in flexion had significantly lower distraction stiffness than those showing segmental lordosis in flexion.
Disc angle in flexion and ROM were the most prognostic parameters of lumbar distraction instability. Although the option of spinal arthrodesis method should be determined based on both clinical manifestation and imaging studies, the current study demonstrated that providing of anterior column support is biomechanically reasonable for degenerative spondylolisthesis with segmental kyphosis in flexion.
Infusion reactions are a major side effect of the administration of therapeutic Abs and are the result of a complex immune reaction. In this study, we report that substitutions of Fc amino acids in ...the anti-HLA-DR Ab HD8 reduce its ability to induce infusion reactions in rats and monkeys. We first showed that i.v. administration of IgG1- and IgG2-subclass HD8 Abs induces severe infusion reactions in monkeys. These Abs express strong complement-dependent cytotoxicity (CDC), and in vivo depletion of complement in rats by pretreatment with cobra venom factor abrogated the lethal infusion reactions generated by HD8-IgG1. Thus, the infusion reactions appear to be largely driven by the complement system. To reduce the CDC function of HD8-IgG1, its Fc region was modified by two amino acid substitutions at Pro(331)Ser and Lys(322)Ala. The modified Ab was incapable of expressing CDC in vitro and did not induce severe infusion reactions in rats and monkeys, even at extremely high doses. The modified Ab retained its Ab-dependent cellular cytotoxicity function as well as its antitumor activity in a tumor-bearing mouse model. In summary, complement appears to drive infusion reactions, and modifications that eliminate the CDC activity of an Ab also reduce its ability to induce infusion reactions.
Background: Recently, therapeutic strategies for a metastasectomy from colorectal carcinoma after chemo-targeted therapy with bevacizumab have been presented, with which some uncommon but serious ...adverse events have been reported. However, only few reports have investigated the safety of lung resection after such therapy or the histological effects. We retrospectively analyzed the both of them at our institute. Methods: Of 69 colorectal carcinoma patients who underwent pulmonary metastasectomy procedures from 2009 to 2014, we investigated 11 who also received chemo-targeted therapy prior to surgery. Results: In addition to bevacizumab, 5 fluorouracil (FU)/leucovorin + oxaliplatin or capecitabine was given in 6 cases and 5 FU/leucovorin + irinotecan in 5 cases. The mean period from the end of chemo-targeted therapy to surgery was 2.7 ± 0.9 months. The response to therapy shown in imaging findings was progressive disease in 6, stable disease in 3, and partial response in 2 (response rate, 18.2%). The operation modes were wedge resection (n = 8, 72.3%), segmentectomy (n = 2, 1 in bilateral lobes, 1 in the right lobe, 18.2%), and lobectomy (n = 1, left lower lobectomy, 9.1%). All patients safely underwent a complete resection. As for postsurgical complications, chylothorax occurred in 1 case and prolonged pulmonary air leakage in 1 case. The histological effects of chemo-targeted therapy were slight. There was no relationship between histological findings with imaging findings obtained prior to the operation (p = 0.63). The 5-year disease-free survival rate after metastasectomy was 10.9%. Conclusions: Pulmonary metastasectomy after chemo-targeted therapy for colorectal carcinoma patients obtained acceptable results. In addition, there was no correlation between imaging and histopathologic results following chemo-targeted therapy.
The molecular aggregation state of octadecylsiloxane monolayers on Si-wafer substrate surfaces prepared from octadecyltrimethoxysilane (OTMS) or octadecyltrichlorosilane (OTS) was investigated on the ...basis of grazing incidence X-ray diffraction (GIXD), Fourier transform infrared spectroscopy (FT-IR), contact angle measurement, field emission scanning electron microscopy (FE-SEM), and scanning force microscopy (SFM). The OTMS monolayer was prepared by using the chemical vapor adsorption (CVA) method, and the OTS monolayers, which were used as reference samples, were prepared either by chemisorption (OTS-S) or by the water-cast method (OTS-W). The GIXD, FT-IR, lateral force microscopic (LFM) measurements, and FE-SEM observation revealed that the alkyl chains in the OTMS monolayers prepared using the CVA method are in an amorphous state at room temperature. According to the LFM measurement, the transition temperature from the hexagonal crystalline phase to the amorphous phase was found to be ca. 333 K for the OTS-S monolayer prepared by the chemisorption method. However, the phase transition was not observed in the OTMS monolayer prepared by the CVA method. Also, the atomic force microscopic (AFM) observation and the contact angle measurement showed that the OTMS monolayer prepared by the CVA method has a uniform surface when compared to the OTS monolayers. These results indicated that organosilane compounds in the monolayer prepared by the CVA method were immobilized on the Si-wafer substrate surface in an amorphous state, which was quite different from the hexagonal crystalline state obtained by the chemisorption and water-cast methods.
Purpose
The sagittal fibular axis serves as an intra-operative landmark during conventional total knee arthroplasty (TKA); however, only a few relevant anatomical studies have been published ...regarding its use as an extramedullary guide. Furthermore, the correlation between the coronal fibular and tibial mechanical axes in osteoarthritic knees has been only reported once. Here, the hypothesis of this study is that the fibula can be a reliable intra-operative landmark, in the sagittal and coronal planes, among patients with osteoarthritis who have undergone TKA.
Methods
Osteoarthritic knees (
n
= 62) after TKA were evaluated using three-dimensional image-matching software. The angles between the tibial mechanical axis and the fibular shaft axis were measured in the sagittal and coronal planes. Moreover, correlations between the angles and patient-specific factors were evaluated.
Results
The mean angle between the tibial mechanical and fibular shaft axes was 2.6° ± 2.3° for posterior inclination in the sagittal plane and 0.9° ± 2.0° for varus inclination in the coronal plane. The percentage of subjects with the fibular shaft axis within 2° of the tibial mechanical axis was 17.7 and 69.3 % in the sagittal and coronal planes, respectively. No patient-specific factors were correlated with the angle between the tibial mechanical and fibular shaft axes.
Conclusions
The angle between the tibial mechanical and fibular shaft axes differed among patients, independent of patient-specific factors, and did not appear to be a reliable intra-operative landmark. Surgeons should use values from individual pre-operative evaluations of the axis as reference for conventional TKA.
Level of evidence
Case series with no comparison group, Level IV.
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